Inflatable dilator



April 10, l951 L. GREENBURG INFLATABLE DILAToR Filed April 9, 1948 a N., E m w .w n: D II l Patented Apr. 10, 1951 UNITED STATES PATENT OFFICE INFLATABLE DILATOR Leonard Greenburg, New York, N. Y.

Application April 9, 1948, Serial No. 20,024

16 Claims. 1

This invention relates to surgical accessories and to a method of surgery. More particularly, it relates to a surgical accessory for examining and enabling medical or surgical treatment of internal body organs or cavities, and also to a surgical method for gaining access to such organs or cavities.

In the practice of medicine and surgery it is often desirable to examine and treat various internal body cavities and organs such as the urinary bladder, lungs, stomach and rectum. Heretofore, in such operations, it has been the practice to insert a hollow metal tubular instrument into the internal organ or cavity through a canal or passage leading from the exterior of the body to such organ or cavity. During insertion of the instrument, the body canal through which it is passed is dilated and straightened, at least to some extent and after the instrument is fully inserted the interior of the organ or cavity may be examined and treated through the instrument. The use of such metal instruments causes considerable pain to the patient and there is the accompanying danger of injuring the passage tissues during insertion of the instrument. Other diiculties .in operative techniques when utilizing such metal instruments are well known to the medical and surgical professions.

This invention provides a surgical accessory or instrument for examination and treatment of internal body organs or cavities and which may be inserted into the organ or cavity through an externally terminating body passage in a soft, exible, non-rigid condition, but which, after insertion, may be straightened and made rigid to provide access through the instrument to the organ or cavity.

The invention further provides a surgical accessory of the type described which may be used with little or no pain to the patient and without danger of injuring the patient.

The invention also provides a new surgical technique or method of gaining access to internal body cavities or organs, which technique may be employed without causing pain to the patient and without injuring the patient.

A surgical accessory constructed in accordance with this invention comprises a double-walled, flexible, rubber tube, having one or more passages disposed between the two walls. The ends of the passages are hermetically closed, but the ends of the central bore of the tube are left open. A nipple or other suitable means, connected to the accessory and communicating with at least one of the closed passages in the double-walled portion, is provided for introducing fluid pressure into such passages, and means are provided in the tube for establishing intercommunication between the passages. The portions of the tube between the passages structurally strengthen the accessory, also provide for uniform expansion and distension thereof, and prevent collapse of the inner wall upon introducing uid pressure into the passages in the closed double-walledportion.

Several modifications of a surgical accessory constructed in accordance with this invention are shown in the accompanying drawing, in which:

Fig. 1 is an elevational view of the tubular surgical accessory;

Fig. 2 is an enlarged vertical sectional view taken along the line 2 2 of Fig. 1' and showing one modification of the accessory;

Fig. 3 is a transverse sectional view taken along the line 3--3 of Fig. 2;

Fig. 4 is an enlarged, vertical sectional view similar to Fig. 2, but showing a dierent modication;

Fig. 5 is a transverse sectional view taken along the line 5 5 of Fig. 4;

Fig. 6 is an enlarged vertical sectional view similar to Fig. 2, but showing'another modication;

Fig. '7 is a transverse sectional view taken along the line 'l-'l of Fig. 6; and

Fig. 8 is a transverse sectional view similar to Fig. 5 but showing a spiral arrangement of the ribs between the inner and outer tubes.

As shown in the drawings and particularly with reference to Fig. 2, the tubular accessory comprises an open ended, flexible, rubber tube l0, within the wall I I of which one or more longitudinally extending passages I2 are formed, thus providing a double-Walled structure. The passages are closed at one end I2a within the tube wall and terminate at the other end I2b in a header I3. The header may be formed integrally with the tube-wall or it may be formed in a separate unit and joined to the tube adjacent the ends I2b of the passages. connected to one end of the tube communicates with header I3', and the other end of the tubewall advantageously is tapered as shown at IIa.: to facilitate insertion of the accessory through the body passages or canals.

Instead of terminating in the header I3, the ends I2b of the passages I2 may terminate separately within the tube wall, in which event the nipple Ill communicates with one of the passages and small canals or apertures, such as shown in phantom at l5 in Fig. 3, extending through the portions of the tube wall between the passages, provide intercommunication between Athe pas- A nipple I4 sages. Such intercommunicating apertures may also be employed with the header arrangement shown in Fig. 2, if desired.

The modication of the invention shown in Figs. 4 and 5 comprises a nexible, rubber, outer tube I6 and an open-ended exible, rubber, inner tube I1 of smaller diameter than tube I6. The inner tube is arranged within and spaced from the outer tube, thereby providing an annular passageway between the two tubes. The ends of the outer tube are hermetically closed upon the inner tube as by tapering or curving the insertion end portion ISa of the outer tube in toward the inner tube and securing this end, as by Y means of vulcanization, rubber cement or the like, to the inner tube. The other end of the outer tube may be provided with an inwardly extending portion I6b which is hermetically joined as by vulcanization, rubber cement or the like, to the inner tube.

A plurality of spaced, longitudinally extending, web-like ribs I8 are disposed within the annular passageway between the inner and outer tubes and divide this passageway into a plurality of passages I8. The ribs I8 extend between and join the two tubes and may be formed integrally with both or one of the tubes as shown in Fig. 5, or they may be made separate from the two tubes and vulcanized or cemented to the tubes. A nipple I4 connected to the outer tube communicates with one of the passages I9, and several apertures or perforations 2D are provided in the ribs IB for establishing intercommunication between the passages. The web-like ribs may extend substantially parallel to the axis of the tube as shown in Figs. 4 and 5, or they may be oi other form (e. g. spiral as illustrated in Fig. 8).

In the modication shown in Figs. 6 and 'l the inner and outer tube type of construction is employed but the annular passageway between the tubes is filled with a sponge-like rubber mass 2I which is connected to the walls of the tubes. The mass 2| has a cell structure with intercommunicating interstices, and a portion of the annular passageway between the two tubes is left vacant so as to provide an annular header 22, with which the nipple I4 communicates. A header arrangement similar to that shown in Figs. 2 and 6 may also be utilized with the web-like rib structure shown in Figs. 4 and 5. in which event the apertures 2D may be eliminated.

To facilitate observation and inspection oi internal body organs or cavities with this accessory, a small electric lamp may be located at or near the insertion end of the accessory and the wires for the lamp may be imbedded in the tube walls of the embodiments shown in Figs. 2 and 6, or they may extend through one of the passages i2 or I8, respectively, of the embodiments shown in Figs. 2 and 4, being imbedded within the insertion ends IIa, IIa, respectively, of these embodiments.

In any of the various modications, one or more longitudinally extending partitions such as shown at 23 in Fig. 6 may be secured within the central bore of the tube to provide a plurality of open ended passages within the tube. The partition may be molded integrally with the tubular member or it may be made as a separat.J member and secured to the walls of the central bore of the tube by vulcanization, rubber cement or the like. With such arrangement, observation may be made through one of the bore passages while manipulation or treatment, including introduction and/or withdrawal of fluid is being accomplished .while permitting observation and/or treatment through others.

In use, a surgical accessory constructed in accordance with this invention is usually inserted into the body cavity through the externally ending body passage while in a flexible, non-rigid or non-distended condition so that it can readily follow the general shape or curvature of the passage or canal through which it is passed. I-Iowever, if desired, the tube may be contracted during the insertion operation by applying suction to the closed passages between the inner and outer walls of the tube. This is accomplished by connecting a source of suction or vacuum to the nipple I4. In some instances it may be desirable to distend the accessory somewhat, Aor to render it somewhat rigid, during the insertion through the body passage. This may be accomplished by admitting a suitable amount oi superatmospheric fluid pressure into the passages between the inner and outer tubes.

In the normally non-distended condition or in the above-described contracted or slightly distended conditions, the instrument has a high degree of flexibility and may be inserted through the body passage without causing pain to the patient. Inasmuch as the accessory is composed oi rubber or rubber-like material which is soit and flexible, it may be inserted through the body passage without danger of injuring the passage tissues. The inwardly tapered end portion permits the instrument to be inserted through the body passage with minimum discomfort to the patient.

After the instrument has been positioned properly within the body passage so that its innerv end lies in the body cavity or organ which is to be examined or treated, uid pressure is introduced into the passages between the inner and outer walls of the tube. Upon introducing a suitable amount of fluid pressure into the doublewalled portion, the instrument will distend and expand, thus making the instrument rigid and tending to straighten it within the body passage, thereby dilating the body passage and providing a substantially unobstructed passageway from the exterior of the body directly into the body cavity or organ involved.

In some instances it may be desirable that the tube have a certain curvature while in the distended or rigid condition. This may be accomplished by moulding the tube in the desired shape, by decreasing or increasing the size of the passages dened by the strengthening ribs at a particular location between the walls of the tube, by the use oi less elastic rubber in one portion of the tube than in other portions, or by a combination of two or more of these procedures. The inner end oi the central bore need not necessarily terminate in the end of tube, but instead may terminate in a side of the insertion end portion of the accessory.

Although the accessory has been described as being made of rubber it is to be understood that other relatively soft, resilient, flexible materials such as synthetic plastics and the like may be utilized, and the use of the word rubber in the claims includes such other material. Various other modifications in the arrangement of elements and in the details of construction of the accessory may be made without departing from the spirit and scope of the invention.

I claim:

1. A surgical accessory for examining and treating internal body cavities, comprising a double-walled, flexible, open-ended, rubber tube having a plurality of passages extending substantially the entire length of the tube and disposed between the inner and outer walls, means hermetically closing the ends of the said passages, and means for introducing fluid pressure into said passages, thereby to subject the accessory to the effect of the fluid pressure confined within said passages.

2. A surgical accessory as dened in claim 1 in which the fluid pressure introducing means comprises a nipple attached to said tube near one end thereof, said nipple communicating directly with at least one of said passages.

3. A surgical accessory as defined in claim 2 in which the end portion of said tube opposite the end near which said nipple is attached is tapered inwardly toward the central bore of said tube.

4. A surgical accessory as dened in claim 1, including apertures extending through portions of said tube wall between adjacent pairs of said passages to provide intercommunication between said passages.

5. A surgical accessory for examining and treating internal body cavities, comprising a doublewalled, flexible, open-ended rubber tube having a plurality of passages extending substantially the entire length of the tube and disposed between the inner and outer walls, means hermetically closing the ends of said passages, a common header communicating with said passages, and means for introducing fluid pressure into said header thereby to subject the accessory to the effect of the fluid pressure confined within said passages.

6. A surgical accessory for examining and treating internal body cavities, comprising a flexible, open-ended rubber tube having a plurality of longitudinally extending passages extending substantially the entire length of the tube and disposed within the tube walls, means hermetically closing the ends of said passages, and means for admitting fluid pressure into said passages, thereby to subject the accessory to the effect of the fluid pressure coniined within the said passages.

7. A surgical accessory as defined in claim 6, in which said last-named means includes a common header communicating with said passages.

8. A surgical accessory as defined in claim 6, in which said last-named means includes apertures extending through portions of the tubewall between adjacent pairs of said passages.

9. A surgical accessory for examining and treating internal body cavities, comprising a pair of ilexible rubber tubes, one of which is disposed within and spaced from the other thereby providing an annular passageway between said tubes extending substantially the entire length thereof, means hermetically closing the ends of said passageway, web means disposed within said passageway and joining said tubes, and means for introducing fluid pressure into said passageway thereby to subject the accessory to the effect of the fluid pressure confined within said passageway.

10. A surgical accessory for examining and treating internal body cavities, comprising an outer exible rubber tube, an inner iiexible rubber tube arranged within and spaced from said outer tube thereby providing an annular passageway between said inner and outer tubes and extending substantially the entire length thereof, means hermetically closing the ends of said passageway, a plurality of web-like ribs disposed within said passageway and connecting said inner and outer tubes, thereby dividing said closed passageway into a plurality of passages, and means for introducing fluid pressure into said passages thereby to subject the accessory to the effect of the fluid pressure confined within said passages.

11. A surgical accessory as defined in claim 10, in which the iluid pressure introducing means comprises a nipple attached to said outer tube and communicating directly with at least one of said passages.

12. A surgical accessory as dened in claim 10, and including apertures in said web-like ribs providing intercommunication between said passages.

13.` A surgical accessory as dened in claim 10, in which said ribs are arranged spirally within said passageway.

14. A surgical accessory as denned in claim 10, in which said ribs are arranged substantially longitudinally within said passageway.

15. A surgical accessory for examining and treating internal body cavities, comprising an outer flexible rubber tube, an inner flexible rubber tube arranged within and spaced from said outer tube thereby providing an annular passageway between said inner and outer tubes and extending substantially the entire length thereof, means hermetically closing the ends of said passageway, a plurality of web-like ribs disposed within said passageway and connecting said inner and outer tubes, thereby dividing said closed passageway into a plurality of passages, a common header communicating with said passages, and means for introducing fluid pressure into said header thereby to subject the accessory to the effect of the fluid pressure confined within said passages.

16. A surgical accessory for examining and treating 'internal body cavities, comprising an outer flexible rubber tube and inner flexible rubber tube arranged within and spaced from said outer tube, thereby providing an annular passageway between said inner and outer tubes extending substantially the entire length thereof, means hermetically closing the ends of said passageway, a sponge-like rubber mass having intercommunicating interstices disposed within said passageway and connecting said inner and outer tubes, and means for introducing uid pressure into the interstices of said sponge rubber mass thereby to subject the accessory to the effect of the fluid pressure conned within said interstices.

LEONARD GREENBURG.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 118,683 Bruce Sept. 5, 1871 1,383,944 Hart July 5, 1921 1,598,284 Kinney Aug. 31, 1926 1,636,482 Newton July 19, 1927 2,308,484 Auzin et al. Jan. 19, 1943 FOREIGN PATENTS Number Country Date 334,404 Italy Jan. 25, 1936 

